Page 1 of 5 REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION P.O.

BOX 2038 MANILA BOARD OF NURSING Record of Operating and Delivery Room Cases and Cord Care Name of student: ZAMORAS, CELESTINA CAMANSE Name and Address of School: Andres Bonifacio College, College Park, Dipolog City Accreditation Level (if any): N/A Date School/Program was recognized: February 20 First Course (if any): N/A Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007

Year Granted: N/A Number: 002 School Graduated: N/A

Year: 2006 Year: N/A

No. 1

Date of Operation June 18, 2007 July 4, 2007 July 11, 2007 July 12, 2007

Case No. 08-44-56

Name of Patient Pacatan, Flory Cris Incong, Florencia Pacarro, Anecito Candawan, Analiza

Diagnosis

I. Major Operations Operation Performed Type of Anesthesia Mastectomy General Anesthesia Spinal Anesthesia

Name of Surgeon Dr. Nelson H. Gallemit Dr. Livera A. Amil

Name of Hospital

Name of O.R. Scrub Nurse Mrs. Rosini C. Rudas, BSN-RN, MN Mrs. Carlene I. Puliran, BSN-RN, MN Mrs. Carlene I. Puliran, BSN-RN, MN Mrs. Carlene I. Puliran, BSN-RN, MN

Signature of O.R. Scrub Nurse

Invasive Duct al Cancer, Left Breast G3P2 Pre-eclampsia

Dr. Jose Rizal Memorial Hospital Misamis Occidental Provincial Hospital Misamis Occidental Provincial Hospital Misamis Occidental Provincial Hospital Misamis Occidental Provincial Hospital

15-76-38

Cesarean Section with Bilateral Tubal Ligation Orchidectomy

15-78-05

Testicular Tumor

Spinal Anesthesia

Dr. Lemuel Q. Uy

15-78-86

Ruptured Appendicitis with Localized Peritonitis

Exploratory Laparotomy,Appendectomy Lavage with Delayed Primary Closure Cesarean Section

Spinal Anesthesia

Dr. Olyzar H. Recamadas

July 12, 2007

15-79-16

Omendan, Ludette

Pregnancy Uterine Full Term in Labor, Mild Preeclampsia, Protracted Active Phase of Labor secondary to Cephalopelvic Disproportion and Fetal

Spinal Anesthesia

Dr. Marifel M. Uy

Mrs. Carlene I. Puliran, BSN-RN, MN

Distress Page 2 of 5 REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION P.O. BOX 2038 MANILA BOARD OF NURSING Record of Operating and Delivery Room Cases and Cord Care

Name of student: ZAMORAS, CELESTINA CAMANSE Name and Address of School: Andres Bonifacio College, College Park, Dipolog City Accreditation Level (if any): N/A Date School/Program was recognized: February 20 First Course (if any): N/A Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007

Year Granted: N/A Number: 002 School Graduated: N/A

Year: 2006 Year: N/A

No. 1 2

Date of Operation April 25, 2006 November 7, 2006 April 3, 2007

Case No. 00-34-47 06-35-31

Name of Patient

Diagnosis

II. Minor Operations Operation Performed Type of Anesthesia Excision of Lipoma at Left Breast Excision of Mole at Right Pre-Auricular area Suturing of Lacerated Wound, Right Arm Dilatation and Curettage Local Anesthesia Local Anesthesia

Name of Surgeon Dr. Nelson H. Gallemit Dr. Nelson H. Gallemit Dr. Nelson H. Gallemit Dr. Lorna G. Yap

Name of Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Misamis Occidental Provincial Hospital Dr. Jose Rizal

Name of O.R. Scrub Nurse Mrs. Adora J. Tambasen, BSN-RN, MN Mrs. Adora J. Tambasen, BSN-RN, MN Mrs. Adora J. Tambasen, BSN-RN, MN Mrs. Carlene I. Puliran, BSN-RN, MN

Signature of O.R. Scrub Nurse

Sabehon, Percy Adaza, Ernie

Lipoma at Left Breast Mole at Right PreAuricular Area Lacerated Wound, Right Arm Incomplete Abortion

06-52-44

Acaylar, Aldo

Local Anesthesia

July 13, 2007

15-79-52

Aclo, Charmaine

Spinal Anesthesia

August 11,

06-06-61

Bagsican, Edgar

Foreign Body at

Removal of Foreign

Local Anesthesia

Dr. Nelson H.

Mrs. Adora J. Tambasen,

2007

Right Nasal Opening

Body at Right Nasal Opening

Gallemit

Memorial Hospital

BSN-RN, MN

Prepared by: Celestina C. Zamoras Name of student Supervised by: Eldridge Roy B. Mandalupa Signature over printed name of Clinical Instructor Date Signed: Degree: BSN, RN, MN a. PRC No.: 0255227 Valid Until: July 30, 2009 b. PNA No.: 35927 Valid Until: December 2007 c. ORNAP No.: 07-0244 NM Validity: June 30, 2008 Noted by: Precy Nelia C. Gilaga Signature over printed name of Clinical Coordinator Date Signed: Degree: BSN, RN, MN a. PRC No.: 0232343 Valid Until: July 31, 2008 b. PNA No.: 15890 Valid Until: December 2007 Concurred by: Dulce O. Bajamunde Signature over printed name of Chief Nurse, DJRMH Date Signed: Degree: BSN, RN, MN a. PRC No.: 0050114 Valid Until: March 1, 2009 b. PNA No. 15911 Valid Until: December 2007 Daisy C. Mondoy Signature over printed name of Chief Nurse, MOPH Date Signed: Degree: BSN, RN, MN, MBA a. PRC No.: 0069147 Valid Until: June 14, 2009 b. PNA No.: 20506 Valid Until: December 31, 2007 c. ANSAP No.: 00009 Valid Until: December 31, 2007 Approved by: Dalisay M. Dumalag Signature over printed name of Dean Date Signed: Degree: BSN, RN, MAN, PhD a. PRC No.00015877 Valid Until: April 28, 2008 b. PNA No.1883 Valid Until: Lifetime member c. ADCPN No. 12010 Valid Until: October 2008

I declare under oath that these cases had been accomplished by me in good faith, verified by me to the best of my knowledge and belief is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. ________________________________ Signature of Applicant Subscribed and sworn to before me this_____ day of , in the City of Dipolog, Philippines

NOTARY PUBLIC Doc No. Page No. Book No.

Series No.

Page 3 of 5 REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION P.O. BOX 2038 MANILA BOARD OF NURSING Record of Operating and Delivery Room Cases and Cord Care

Name of student: ZAMORAS, CELESTINA CAMANSE Name and Address of School: Andres Bonifacio College, College Park, Dipolog City Accreditation Level (if any): N/A Date School/Program was recognized: February 20 First Course (if any): N/A Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007

Year Granted: N/A Number: 002 School Graduated: N/A

Year: 2006 Year: N/A

III. Actual Delivery No. Case No. Diagnosis Name of Mother Age Date of Delivery September 10, 2006 September 30, 2006 December 11, 2006 December 11, 2006 January 2, 2007 Time of Delivery 7:45 am Gender of Baby Female Name of Hospital Type of Delivery Supervised by: Name and Signature of C.I.

31-94-30

Pregnancy Uterine Full Term, delivered to a live Baby Girl, cephalic presentation, G1P1 Pregnancy Uterine Full Term, delivered to a live Baby Boy, cephalic presentation, G1P1 Pregnancy Uterine Full Term, delivered to a live Baby Girl, cephalic presentation, G4P4 Pregnancy Uterine Full Term, delivered to a live Baby Girl cephalic presentation, G4P4 Pregnancy Uterine Full Term, delivered to a live Baby Boy,

Inding, Susan

21

Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital

Normal Spontaneous Vaginal delivery Normal Spontaneous Vaginal delivery Normal Spontaneous Vaginal delivery Normal Spontaneous Vaginal delivery Normal Spontaneous Vaginal delivery

Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN

08-00-46

Patoc, Edna

35

9:10 am

Male

05-48-10

Catian, Jocelyn

34

10:35 am

Female

04-74-23

Lomocas, Josephine Apolinario, Janet

38

10:47 pm

Female

Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao,

08-17-73

25

11:04 am

Male

cephalic presentation, G1P1

BS-RN Page 4 of 5 REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION P.O. BOX 2038 MANILA BOARD OF NURSING Record of Operating and Delivery Room Cases and Cord Care

Name of student: ZAMORAS, CELESTINA CAMANSE Name and Address of School: Andres Bonifacio College, College Park, Dipolog City Accreditation Level (if any): N/A Date School/Program was recognized: February 20 First Course (if any): N/A Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007

Year Granted: N/A Number: 002 School Graduated: N/A

Year: 2006 Year: N/A

IV. Deliveries Assisted No. Case No. Diagnosis Name of Mother Age Date of Delivery May 22, 2006 Time of Delivery 10:43 am Gender of Baby Female Name of Hospital Type of Delivery Supervised by: Name and Signature of C.I. Mr. Christian Churchill B. Sidlao, BSN-RN

07-75-32

Pregnancy Uterine Full Term, delivered to a live Baby Girl, cephalic presentation, G3P3 Pregnancy Uterine Full Term, delivered to a live Baby Girl, cephalic presentation, G1P1 Pregnancy Uterine Full Term, delivered to a live Baby Boy, cephalic presentation, G2P2 Pregnancy Uterine Full Term, delivered to a live Baby Boy cephalic presentation, G1P1 Pregnancy Uterine Full Term, delivered to a live Baby Girl, cephalic presentation, G2P2

Senio, Rebecca

37

Dr. Jose Rizal Memorial Hospital

Normal Spontaneous Vaginal delivery

07-96-22

Dumasig, Rodelina

22

September 7, 2006

7:46 am

Female

Dr. Jose Rizal Memorial Hospital

Normal Spontaneous Vaginal Delivery

Mr. Christian Churchill B. Sidlao, BSN-RN

05-59-95

Lactuan, Ava Glenda

26

December 9, 2006 December 14, 2006 January 1, 2007

2:00 pm

Male

Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital Dr. Jose Rizal Memorial Hospital

Normal Spontaneous Vaginal delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal delivery

Mr. Christian Churchill B. Sidlao, BSN-RN

08-14-18

Bautista, Maribel

22

7:44 am

Male

Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN

06-58-01

Cabilin , Leah

28

2:45 pm

Female

Page 5 of 5 REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION P.O. BOX 2038 MANILA BOARD OF NURSING Record of Operating and Delivery Room Cases and Cord Care

Name of student: ZAMORAS, CELESTINA CAMANSE Name and Address of School: Andres Bonifacio College, College Park, Dipolog City Accreditation Level (if any): N/A Date School/Program was recognized: February 20 First Course (if any): N/A Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007

Year Granted: N/A Number: 002 School Graduated: N/A

Year: 2006 Year: N/A

V. Cord Dressing No. 1 Case No. 07-61-44 Date Performed March 10, 2006 Name of Baby Ivon Clifford Alcaria Gender of Baby Male Name of Mother Alcaria, Milojean Age 32 Name of Hospital Dr. Jose Rizal Memorial Hospital Supervised by: Name and Signature of Qualified C.I. Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN Mr. Christian Churchill B. Sidlao, BSN-RN

07-22-42

September 28, 2006

Dorothea Marie Ramos

Female

Ramos, Nila

28

Dr. Jose Rizal Memorial Hospital

08-00-43

October 1,2006

Natasha Nichole Bayron

Female

Bayron, Chinalyn

31

Dr. Jose Rizal Memorial Hospital

05-62-51

December 14, 2006

Brian James Villadarez

Male

Villadarez, Sheryl

24

Dr. Jose Rizal Memorial Hospital

05-00-14

February 1, 2007

Adrian Paul Fernandez

Male

Fernadez, Winda

25

Dr. Jose Rizal Memorial Hospital

Prepared by: Celestina C. Zamoras Name of student Supervised by: Noted by: Concurred by: Approved by:

Eldridge Roy B. Mandalupa Signature over printed name of Clinical Instructor Date Signed: Degree: BSN, RN, MN a. PRC No.: 0255227 Valid Until: July 30, 2009 b. PNA No.: 35927 Valid Until: December 2006 c. ORNAP No.: 07-0244 NM Validity: June 30, 2008

Precy Nelia C. Gilaga Signature over printed name of Clinical Coordinator Date Signed: Degree: BSN, RN, MN a. PRC No.: 0232343 Valid Until: July 31, 2008 b. PNA No.: 15890 Valid Until: December 2007

Dulce O. Bajamunde Signature over printed name of Chief Nurse Date Signed: Degree: BSN, RN, MN a. PRC No.: 0050114 Valid Until: March 1, 2009 b. PNA No. 15911 Valid Until: December 2007

Dalisay M. Dumalag Signature over printed name of Dean Date Signed: Degree: BSN, RN, MAN, PhD a. PRC No.00015877 Valid Until: April 28, 2008 b. PNA No.1883 Valid Until: Lifetime member c. ADCPN No. 12010 Valid Until: October 2008

I declare under oath that these cases had been accomplished by me in good faith, verified by me to the best of my knowledge and belief is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. ________________________________ Signature of Applicant Subscribed and sworn to before me this_____ day of in the City of Dipolog, Philippines

NOTARY PUBLIC Doc No. Page No. Book No. Series No.